The Stacked-DIEP flap allows a breast to be reconstructed with significantly more tissue than is possible using either a DIEP flap or a TRAM flap. This innovative procedure uses two DIEP flaps––one DIEP flap from each side of the abdomen––to reconstruct a single breast. This approach allows for excellent results in many women who thought they don’t have enough fatty tissue or were previously told by other health care providers that they were not candidates for a DIEP or TRAM flap.

“Body Lift Breast Reconstruction,” or “extended DIEP” flap breast reconstruction can be a solution for restoring both breasts with natural living tissue for women whose tummy tissue is not sufficient to permit reconstruction using ordinary DIEP flaps. Body lift breast reconstruction uses two flaps for each breast—four flaps in total—to provide adequate tissue to reconstruct two breasts. By combining tissue from the abdomen and the flanks, this approach is well suited for many women who have been told that they “do not have enough tissue” for a natural-tissue breast reconstruction.

Using LAP flaps, it is possible to reconstruct a woman’s breasts with soft tissue removed from the fatty areas at the side of the waist (areas sometimes referred to as “love-handles.” This approach tends to narrow the waistline and lift the buttock. The scar that results from LAP flap surgery falls where the buttock and lower back meet along the waistline. As is the case for all perforator flaps used in breast reconstruction, no muscle is used.

The skin and fat of the upper thigh can be used to reconstruct breasts with a natural appearance. PAP flaps, DUG flaps and TUG flaps can be good choices for reconstruction of small or medium-sized breasts, or for partial breast reconstruction following lumpectomy.

For women who cannot use—or choose not to use—tissue from their abdomen or other donor sites such as the lumbar region or the thighs, SGAP and IGAP flaps are an alternative for natural-tissue breast reconstruction after mastectomy. With both GAP flaps, the tissue used to reconstruct a breast is borrowed from the buttock without compromising the gluteal muscles.

Several different techniques of implant breast reconstruction can be used to reconstruct a breast following mastectomy. Some approaches involve placing an implant at the time of mastectomy, allowing reconstruction with a single procedure, while other approaches require two separate surgical procedures. A number of factors will determine which approach is best for each individual.

Nipple reconstruction, in combination with 3-dimensional tattooing, adds realism to a reconstructed breast. Nipple reconstruction adds physical projection and, together with the artistic application of tattoo pigment, can produce a visual and tactile effect that closely resembles a natural nipple and areola.

Breast reduction surgery removes unwanted breast tissue to reduce breast size and contour the breast shape. Breast reduction can be done to produce symmetry with a breast reconstruction on the opposite breast. Surgery can also be done to remove excess tissue that interferes with exercise and other activities, contributes to back, neck and shoulder pain, or because a patient prefers to have smaller breasts.

A breast lift, or mastopexy, is performed to restore a more youthful shape and a firmer feel to the breasts. Breasts can be lifted for cosmetic reasons, or to improve symmetry between a woman’s breasts, or to achieve symmetry between a reconstructed breast and the breast on the opposite side.

With the creative application of sophisticated techniques and innovative solutions, it is possible to improve upon, or correct, even significantly unsatisfactory results from prior surgery or from breast reconstruction failure. We take special interest in helping to restore the bodies and lives of women who suffer from poor outcomes of prior surgery.

Oncoplastic reconstructive surgery can improve the final shape of a woman’s breast when combined with lumpectomy or partial mastectomy. With oncoplastic surgery, remaining breast tissue or tissue from elsewhere can be sculpted to avoid abnormalities in breast shape that can sometimes result from breast-conserving therapy. These techniques can also realign the nipple and areola to give the breast a natural appearance.